Manager, Network Development (Cenpatico)

Manager, Network Development (Cenpatico)

Manager, Network Development (Cenpatico)


Job Title: Manager, Network Development (Cenpatico)
Job Type: Full-Time
Location: Fort Lauderdale, FL








Job Description:

Position Purpose:
Build and maintain provider networks that promote quality customer outcomes. Develop and implement activities for the recruitment, contracting and retention of effective providers to promote evidence-based practices. Partner with providers to track outcomes for members receiving treatment.


Knowledge/Experience:
Bachelor's degree or equivalent experience in behavioral health or related field, master's degree preferred. 3-5 years network development, provider relations, or training experience. Claims and reimbursement system experience and provider business operations knowledge. In-depth knowledge of state compliance and regulatory processes/laws. Behavioral health experience in the public sector and supervisory experience preferred. Working knowledge of managed care industry, behavioral health, evidence-based practices, clinical modalities, behavioral health diagnoses, and levels of care preferred.

Licenses/Certifications: Licensed LCSW, LMFT, LPC or RN with behavioral health experience a plus. Current state driver's license.

Position Responsibilities:

. Meet with contracted providers to develop long-term relationships, resolve operational issues and collaborate regarding effective treatment modalities and outcomes.

. Evaluate and negotiate contracts in compliance with company contract templates and reimbursement structure standards.

. Maintain state governmental and community relationships.

. Evaluate the need for additional providers and/or specialty treatment services for identified populations.

. Analyze provider performance and profiling for interventions data.

. Develop market specific provider network business plans, strategies, and goals.

. Develop and deliver provider orientation, training, and education materials.

. Interface with all levels of the organization in order to ensure provider data accuracy.

. Collaborate to evaluate trends, identify preferred practice patterns and provide further education to providers on clinical initiatives and expectations.

. Collaborate with Centene health plans to integrate models to enrich member's experience.